HomeMy WebLinkAboutBuilding Permit #802 - 56 GLENWOOD STREET 6/15/2006,%ORTh
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
/ SSwCNUSE
Permit NO: �a Z Date Received //
Date Issued: /
IMPORTANT: Applicant must complete all items on this papze
LOCATION G6Oy (A/00 S
Print Dp
PROPERTY OWNER / /-)V L,4
a Print
MAP NO.: -_PARCEL: I ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
❑ One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
OWNER: Name:
Identification Please Type or Print Clearly)
EM,
Address: � (� �� Lc Al k,/ 00 1) $
00? -3
CONTRACTOR Name: /�-1" � � /�- (C Aw /� /`1 'C �G� Phone: Ki%O 3�- 3
Address:
/L' s �- /V4
Supervisor's Construction License: Exp. Date:
Home Improvement License: Exp. Date:
ARCHITECT/ENGINEER Name: Phone:
Address:
Reg. No.
FEE SCHEDULE: BULDING PERMIT. $10 0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost :$ 1 3 , y x10.00=FEE:$
Check No.: Id
Receipt No.: I oZ
Page I of 4
Location C� oo 0G� .
No. kV 2— Date
�ORT� TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # ! Z 1
4 6
Building Inspector
TYPE OF SEWARGE DISPOSAL
Art ❑
Swimming Pools El
Public Sewer
❑
Tobacco Sales ❑
Food Packaging/Sales ❑
Well
Permanent Dumpster on Site ❑
Private (septic tank, etc. ❑
Electric Meter location to
project
NOTE: Persons contracting with
Signature of Agent/Owner
Contractor
Plans Submitted ❑
registered contractors do not have acceItothheuaranty fund
• Signature of
Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Zoning Board of Appeals: Variance, Petition
Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
[]Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
DATE REJECTED
DATE REJECTED
0
Comments
Comments
0
DATE APPROVED
DATE APPROVED
Water & Sewer connection/Signature & Date Driveway Permit
Temp Dumpster on site yes—no
Fire Department signature/date
Building Setback (ft.)
Front Yard
Side Yard Rear Yard
Required
Provided
Required
Provides Required
Provided
ION
Number of Stories:
Total land area, sq. ft.:
Total square feet of floor area, based on Exterior dimensions.
NO 1 E5 and DATA — (For department use)
Page 3 of 4
Doc: INSPECTIONAL SERVICES DEPARTMENT: BPFORM05
Created JMC. Jan.2006
DIM
ENS
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be
obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
Addition Or Decks
❑ Building Permit Application
❑ Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the
Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of
Deeds. One copy and proof of recording must be submitted with the building application
Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05
Page 4 of 4
A
AMERICAN HOME BUILDERS, INC. f ederol I.D. N 0429244(15'
46 Austin Street Mass. Registration # 10 10 15
AMERICAN Newtonville MA 02460 `� e
HOME BUILDERS 1617) 332-2400 •1-800.323-0033 \ 3�
INCOe 10 RATED
S' 1963 ~"Rk AGREEMENT
rote
Nome: la �� J�� _ ._. =�^^� ..L_ 1t� �`tiwe J 4!
Address: ��� __&L._ �V�/t�U<2_... .7�.X.
^ A V
Ci `I1.) Q el m Slate: Lip; �i i - \ 3
Home Phone: e -k-w-ml' 41S� woik Phone:
INCLUDED NOT INCIUDED
A. Cover all Walls d, Gubles withNL,% RIMIUM VINYL SIDING it (Z� ., calor,
B. Remove and Repioce Rollett Wood as Necessary to Pelfurm Work.
C. Furnish and Install Lxtruded Weather Burner Around all Openings in._\ `:color.
D. Furnish and Instal ff w�+�- _Cu tier Posts on Exterior Corners of Home i �J...color.
E. Wrap Name with Insulated Insulated Underloyment System.'
F Furnish and Install Rigid Bottom Stetter System.
G. Remove and Haul Away Existing Siding (Excluding Asbestos(.
H. All Wolk Performed by the Cunnuctor is Fully Covered by Wutkmcn's CnmrAnsntian
and Public liability Insurance_ 1=j
I. Custom Fabricate PREMIUM SOFFIT AND FASCIA SYSTEM for Overhangs
J. Furnish and Instul) Continuous Seearless Gutter Syslem and DownspouTk ")�-,_ Cato,
K. Custom Fobricnte_.-. N- .Premium Window Casement Wraps rI LAA._ 18-, color. (]
L. Custom Fabricate.... `Ar..._Premium Uout Casement Wraps
M. Custom Fabricate_�f&._Premium Gurago Door Casement Wraps In_._ color. C] K-1-
N.
-yN. Furnish and Install\\-- . _Pair of Shutters. Wouvored I _[Raised Panel in 044 [
O. Furnish and Install VN,%. ...-Vinyl Gable Vents:, [ [�
P. Cover Front, Bock, Porch Ceilings/Carport Ceilings (Describe below]
0. Furnish and Install Master Mount Boxes where Necessory.
R. Furnish and Install-.. Double flung PREMIUM VINYL WINDOWS..
S. Furnish and Install. ``\ . -t edews. � NO 1 -t-
" -.-Patio
T. Furnish and Install._.! �� Sliding Doors/French Doors. ri
U. Clean All lob -Related Debt is on a Daily Basis. G_ [.]
Other WO lu be Performed-
TAL PR -
Da Nat Dai
PAYMENT SCHEDULE DOWN PAYMENT HrQRrDBSTART DUE UPUNCOMPLETION t IRAt
AMCUNTQ1t)Lv S --✓- $ .� $rwLl{�—
NOTE: It financing is chosen buyer understands that cancelling the finance agreement does not cancel this aptrement. Buyer n respon;,ible for
any amount Americun liuu,e Builders, Inc. incurs in obtaining financing, including but not limited to tide semch Fees. It shall be in the oblinolion
of the Home Improvement Contruclor to obtain such permits as The Owner's Agent, The Owners who secure their own conshudion related
permits, or deal with unregistered Conituctots will be excluded from the guaranty find pravisions of MGLC, 142A.
Aft Home Improvement Cunduduts and Subcontractors shall be registered by the Director and That any inyuities ulranl n Cnnhnelor or
Subcontractor relating to a tegistruiiun J,ould be directed to: Medur
THE OWNER SHALL PAY FOR THE WORK SY THE FOLLOWING METHODS Hnme Improvement Controdor Regislturiurr
CASH UPON COMPLETK)N " {��� One Ashburton Place, Room 1301
f dY MODERNIZATION LOAN f f Bostr,n. MA 02108
16171727 859A
COMPANY'S GUARANTEE: The cumpuuy gumuntees its workmanship for.__. \_years. It will replace drlmdive material within the
period of guarantee free of charge. All requests for service must be in wtitingf
M This agreement must be accepted by an officer of the con6ocror within thirty 1301 days from the dole of nxec,dion.
You may cancel this Agreement without any liability to you, provided that you send a written notke to the Contractor
by midnight of the third business day fallowing your signing of this agreement, by ordinary mail, posted, by telegram,
en,,,,4W Uml by delivery.
i "Ifir[sl agree(:( that in The event of cancellation of this contract by owner(sl after the Third business day, owners) shall pay conaoctor on
demand (25"%) twenty-five percent of thentract price as Its stipulated damages for the breach of the contract.
WITNESS our hands and sent this........__ -day 2001v
AMERICAN HOME BUILDERS INC.
(SUBJECT TO HOME OrFICE A"RovAI)
Accepted By:.... - — ......._
DO NOT SIGN THIS AGREEMENT BErORE YOU
BEAD IT OR N TN^ERF ARE ANY BLANNKKSPACES.
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THIS 19 TO CERTIFY THAT THE PrAJCIFS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
NAMED ABOVE roR n'4E POI.ICY PERIOD
INDICATM, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWIT14 RESPECT TO WHICH THIS
CEMFICATE MAY BE ISSUFO OR MAY PFHfAIN,
ME INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUEUECT To ALL THE TERMS,
......E.X.C.I,-,U.Si.O.NS..AND .-CONDITIONS .O.F ... SUCH. POLICIES. ..,.U.M.I.Tg..SHOWN MAY WAVEBEEN REDUCED GY PAID CLAIMS.
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SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR To
MAIL - 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICSHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIN THE COMNY, IIS AGENTS OR REPRESENTATIVES.
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West NeMton, KA 02165 COMPANIES AFFORDING COVERAGE
A Admiral Insurance Company
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American Home Builders, rne. OWA'" C Lloyds London
66 Austin Street
Nentonville, USA 02460 A"" 0
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f -W. 13 M CERTIFY T4(AT THE POL0E5 OF INSURANCE LISTED OELOW HAVE BEEN ISRUM TO THE INSURED NAM® ABOVE FOR THE POLICY PeMOO
INDICATED. VDTTRTHSTANDONS ANY REOUIREMENI. TVW OR WN0ITION Of ANY CON ACT OP. OTHER DOCUMENT WITII REVECT TO WFIICI1 THIN
CCRIIT!CATL MAY li IOBUED OR MAY PERIAIN. THE INBLJPA40C AFFORDEO BY THE PWOICC DEOCAMED HEREIN N BUIUECT TO ALL THE
TERMS.
EXCLUCIpR ANO CCNDITIONB OF SUCH POLICIOE. UMTS SHOWN MAY MAVE BEEN ifDUC60 SY PAID CLAIMS.
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SHOULD ANV OF T>~E ABOVE OESCFVAEO POLICIES BE CAVCFILFJ RFF(IRE THE
�1 E%PIAAITION DATE THEREOF. THE 138UING COMPANY WILL ENDEAVon T9
MAUL ,-Q DAYS wftrm + NOTICE TO THE CEFM;IL'AM FOLDER NAMED TO THE
onto Copy LOT, Bur FNLIA!! TO MNL SUCH NOTCE ({HAIt INPOS! ND oellwnDN OP
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LIABILITY OF ANY KIND COMPANY, ITS AGENTS OR REPRESENTATVFS.
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